For eighteen years, Thailand's HIV/AIDS was routinely depicted as the worlds' fastest moving AIDS epidemic up until the early 2000s when the bulk of scholarly and medical literature portrayed it as being largely under control, and thus Thai anti-AIDS efforts over the decade of the 1990s as a success story. The author takes a critical look at the development of AIDS and at the analyses, which were generated over this period, of its nature, and comes to the conclusion that the "problem" of Thai AIDS has been constructed so as to legitimate specific forms of gender and class-based interventions. He argues that perceptions of the Thai AIDS epidemic are influenced by a class-based paternalism and a western middle-class morality, and that many of the "health" interventions this has engendered are in essence little more than attempts in the exercise of power through covert measures of class control in the guise of behavioural surveillance, and through attempts to redraw the moral boundaries of Thai society in the guise of behavioural modification programs. The book offers a sustained and powerful criticism of the normative modeling of the Thais AIDS epidemic in order to elicit new and more effective points of intervention. It speaks not only to the Thai AIDS epidemic but also to AIDS epidemics throughout Buddhist Southeast Asia and elsewhere. Workers in the Thai AIDS sphere are just coming to the realization that the Thai AIDS epidemic is not, in fact, under control, and that there is a massive subterranean AIDS epidemic amongst middle-class youth, an issue addressed directly by this work. The only study based on original research in Northern Thailand and drawing on the breadth of indigenous Thai language (and some Khmer language) materials, this is a timely publication that will find interest with scholars and professionals working in wide variety of fields.
I am an Australian anthropologist who has conducted research on a number of topics in Thailand and elsewhere in Southeast Asia over the past twenty five years. Some of the areas I have worked on include nineteenth century Christian conversion in Northern Thailand (1985-87), development and social change (1992), street children (1995-1998), the development of culturally appropriate AIDS education materials (1996), the trafficking of women and children (2001), adolescent reproductive health (2002), gender-based violence (2005), the impact of pornography on children and youth (2006), and reproductive health/population program issues (2006-2007.). Throughout this period from 1992 to the present I've also worked on a broad range of HIV/AIDS related issues (including alcohol use, the development of new approaches toward risk behavior, on understanding masculinity as one of the "motors" of Thailand HIV/AIDS epidemic, and on prostitution). As those who have read my A New Look at Thai AIDS will know, I have been particularly interested in the manner in which prostitutes and other socially devalued minority groups have not only been subjected to scapegoating, but have also been subject to a wide range of draconian supervision and control measures.
I started working on Thai AIDS issues when, in the early 1990s, some of the people I knew and liked in Northern Thailand started to become ill with AIDS - for them a new and totally unknown disease. I thought that with my background as an anthropologist studying cultural processes in the North of Thailand that I would be able to contribute to lessening the cost of this dreadful disease. Of course I learned very early on that AIDS was considered a medical issue "owned" by biomedical insiders and that in their opinion the works and thoughts of social scientists, and perhaps anthropologists in particular, were generally considered pretty much irrelevant. We were useful in as much as we "knew" the cultures and languages so we could be employed in AIDS research to go out like trained gophers to talk with "the natives" and get the data we were told biomedical science needed from them, and we were also useful to write manuals about issues like cultural sensitivity and about the conduct of rapid risk assessment so that people not trained in social science research and without the grounded understanding that anthropology provides could work in the AIDS sphere. But somehow, within a few short years the importance of local Thai, Lao, Cambodian, Vietnamese or other constructions of culture and of painstaking qualitative research were overridden as the survey style research of biomedicine and the influence of biomedical solutions to the problem of AIDS started to take over. So this issue, the neglect of social science (anthropology in particular) and indigenous constructions of the world, in AIDS research has been something that has motivated much of my own work over the past fifteen years.
Another AIDS lesson learned pretty early on, and which has also motivated me in my research and writing, is that although HIV/AIDS might now be a Thai disease (and Cambodian/Vietnamese and so on disease) that it was not only that biomedicine "owned" the problems of AIDS, but that the bulk of both biomedical and social science AIDS research and "solutions" were a prime field for a range of late twentieth century Western imperialisms justified in the name of public health. Indigenous cultural interpretations of what was going on really were pretty much ignored and Western standards of sexuality and sexual practice were the general measure for risk and general sexual behavior.
As far as HIV/AIDS research was concerned, AIDS research agendas were by and large imposed on non-Western countries by top down funding regimes that dictated both research topics and methodologies. And, of course, the only publications that mattered were those written in English. So, in the case of Thailand, the many Thai language medical and social science publications, and even popular books about AIDS - counseling, treatment, and the experience of living with AIDS - were unread by the many Western experts who went to Southeast Asia to fix the problem of Thai AIDS. Vaccine testing, research ethics - well, all the standard reports tell us there are plenty of ethics.
And so, from the late -1990s onwards I started doing my own self-funded AIDS research, looking at the issues that I considered important, the relationship between various assumptions made in the modeling of the epidemic and the class-based intervention programs they gave rise to and, particularly, the sorts of Orwellian regimes of supervision and bodily control that health-based AIDS prevention and control programs seemed to generate with no consideration being about the ethical and human rights implications of such regimes. Over the years I have published a number of scholarly papers as well as a major monograph with Berghan press (which is probably how you have come to this short bio) that summarizes much of my work up until the mid-2000s - and when I have time I will indeed set up a web site where one or two of these papers that I am advised are difficult to get can be downloaded from. It has been a slow job, periodically working as a consultant anthropologist in the region to, quite literally, pay for the free time I need to think and write - periodically running out of money and so needing to work for a time before continuing writing.
The present? My writing is based on my own ethnographic research in Southeast Asia and is also closely linked to both the Thai and English scholarly social science and medical AIDS literature, so for me writing takes a lot of time. At the moment I am on the point of completing a new monograph on HIV/AIDS, one that I am very excited about. It complements A New Look at Thai AIDS and extends my analysis a long way. So, perhaps I might conclude this bio with a short extract of the postscript from this volume which will give some brief sense of what this will be about - and maybe also something of my feelings of outrage that the situation I talk about here still exists.
"As I sit in my study in Brisbane, Australia, having returned here from my research base in Thailand in order to redraft the final chapters of this book, I read the latest scholarly social science and medical journals dealing with Thailand's AIDS epidemic. Implacable scholarly research reports a low usage rate of condoms in both commercial and recreational sex, of HIV infected persons who spurn the use of antiretrovirals, of people with serious AIDS related illnesses who delay seeking treatment until they are literally forced to do so, and a suspected youth AIDS epidemic that nobody really knows much about. And, as I write this postscript, I find it almost unbelievable that those persons becoming ill with AIDS in the present day were, for the most part, infected with HIV in the early to mid-2000s at a time when I was beginning to draft my first outline.
In the case of the first Thai HIV infections of the late 1980s and early 1990s those infected were unwitting victims, nobody knew much about AIDS. However, since this time Thailand's war against AIDS has been pronounced a success story. We won! All the AIDS education and control campaigns, including the 100% condom program, have been a success. Everyone now knows about the mechanisms of HIV transmission and sexual safety and the statistics have shown falling HIV transmission rates. So what happened? Unlike those early unsuspecting AIDS victims, the last few hundred thousand Thais infected with HIV knew everything......"
So, this is the question for my new book. "What happened?" I examine how a greater involvement of anthropology and the other social sciences in modeling of AIDS epidemics in Thailand and throughout the world, and in the development and implementations of interventions, might have led to better outcomes. I hope it will be finished some time later this year - 2010.
